Got Healthcare?

How about some real solutions to problems for a change?

If you don't really care much for reading about healthcare, go ahead and stop reading now. If you are, and know somebody who might be able to do something about it, please send my blog link to them.

To solve any problem, you first have to understand it. Here are the basics of the healthcare problem:
1. It costs too much.
2. Individuals can't get insurance, especially if they already have a health problem.
3. Our life expectancy keeps rising, partly because we're able to use drugs, surgery, and technology to keep us alive a lot longer than in the past.
4. Providers are in the business for the money rather than more altruistic motives. Healthcare is a profit-making enterprise that's becoming a huge chunk of our GDP.
5. People who have disappointing results are egged on by trial lawyers to sue the doctors & hospitals, which drives up cost further.
6. Medicine is focused on treatment instead of prevention.

It's tempting to throw up our hands and admit defeat. The system is nearly broken, and there seems to be nothing we can do about it. I'd say there's plenty that can be done about it, but every solution has a rich and powerful anti-constituency that will fight to the bitter end to keep them from being implemented.

It's admittedly very high-level, and nothing here is an original idea. However, there isn't anybody on the national scene that I know who is promoting all of these solutions together.

Anyway, here's how we fix the system:
1. Provide employers with attractive tax incentives to cover their employees in comprehensive health plans, including prevention and wellness. I also like Bush's idea for health insurance portability, which allows individuals and families to keep their plan as they change jobs. The logistics might be tricky, but it could be an excellent idea.
2. Let small businesses band together to purchase health coverage for their employees at the same rates the big companies get.
3. Implement tort reform that takes the following form: Before a malpractice lawsuit may be brought against a doctor, hospital, hmo, etc., the complaint must first be presented to a medical review board for determination of whether there is reasonable evidence of malpractice. The board must be made up of a mix of medical professionals and laymen proven to have no conflict of interest, who review each case and the evidence and decide whether the suit has merit. Along with this, get rid of the silly restrictions against suing HMO's for malpractice or improper denial of care.
4. Set up clinics and hospitals and/or provide subsidies to community health service organizations that provide indigent and uninsured patient care. Anyone can avail themselves of the services at these identified providers, and will be asked to pay as much as they can afford up to the limit of standard usual, reasonable, customary established rates. Provide interest-free government-guaranteed loans to help patients pay for their care, and use tax dollars (gasp!) to fill the gaps. For the average person, the message is, "if you need care, come to this location and you'll receive it regardless of your insurance status or ability to pay. However, you will be asked to pay as much as you can afford toward your treatment."
5. At these government-supported public healthcare organizations, focus on teaching hospitals and utilize young medical students as much as possible, supervised of course by professional staff.
6. Provide attractive tax incentives for physicians and surgeons who provide indigent care with minimal or waived fees. For example, a heart surgeon who does 50 bypass surgeries per month could perform 5 per month for uninsured patients, taking whatever they can afford. The difference between what the patient pays and the normal fee for the surgery would be deductible on the surgeon's tax return.
7. Eliminate the mountains of paperwork. The government and private insurers have required such extensive paperwork that providers are getting buried in administrative overhead costs, not to mention delayed payments. A unified, standard electronic reporting form must be developed and accepted by all insurers, which all providers create on their computer system and transmit directly to the appropriate insurer. The technology exists, all that's needed is standards to eliminate the huge and growing costs of compliance with insurer's paperwork requirements.

Yes, my concept is a partnership between government and private healthcare companies. Let's not delude ourselves - we're going to provide these services to everyone, regardless of their ability to pay. So we have to accept the fact that there will always be uninsured people who get sick and need treatment. Rather than turning them away, we should be prepared to subsidize their treatments, surgery and drugs. With help from private organizations, plus hospitals, physicians, and drug companies, along with making it as easy and attractive as possible for all employers to cover their employees, I think the tax-funded portion could be managed.

We've already got Medicare and Medicaid, which are both socialized medicine. All I'm suggesting is that we could manage these programs more efficiently by opening or subsidizing specific clinics, hospitals, nursing homes, etc. for those who don't have private coverage. By the way, these places would not be government-run, but managed by private companies licensed by the government who are encouraged to be efficient and keep costs down while maintaining a high level of service.

Seems pretty simple to me, but of course it isn't perfect. There is no perfect, but there can be pretty good - this approach I think is pretty good.